My scalp is really dry and itchy, what should I do??

Dry itchy scalp is a common concern among my patients.  It can be caused by seborrheic dermatitis,  psoriasis, eczema/ allergic reaction or more serious scarring alopecias.  

The 1st step is to get yourself to a dermatologist for a proper diagnosis, especially if the issue is persistent and you are starting to loose hair.

Seborrheic dermatitis (Dandruff, Cradle Cap) is an inflammatory dermatitis of the scalp caused by a yeast.  It is the most common cause of dry itchy scalp in my office.  It can also occur on the skin between the eyes, around the nose, behind the ears, and on the chin.  It can cause red or light scaly patches on the affected skin.  It can be a life long condition which may resolve on its own.  It waxes and wanes and can be made worse by stress, cold dry weather, decreased immunity and certain neurologic conditions.

There are several over the counter medicated shampoos you can start with if the symptoms are minor or you cant get yourself to the dermatologist.  One of the big issues I have with these shampoos is that they can be very drying to the hair.  If you are going to use these shampoos, make sure that you pre-condition and oil your hair SHAFT and apply the shampoos only to the SCALP.  Avoid widespread use of these shampoos on the hair shafts as this may result in dry brittle hair.  It may also be wise to deep condition the hair before styling.  Apply once to three times a week and allow to sit on the scalp for 5-10 minutes

When purchasing shampoos look for active ingredients that are anti-inflammatory and anti-yeast such as coal tar, ketoconazole, selenium sulfide, or zinc pyrithione

I also have several patients who want natural alternatives to itchy dry scalp.  I can't stress enough the importance of making an appointment with a dermatologist if your symptoms persist.  Again look for active ingredients that are anti-inflammatory.  Emu oil has anti-inflammatory and anti-oxidant properties.  In a 2013 study of 126  patients, emu oil demonstrated some efficacy in improving the redness and scales of seborrheic dermatitis. It is important to note that it was not as effective as topical hydrocortisone and ani-fungals.  Other natural ingredients that may be helpful in treating itchy scalp/ seborrheic dermatitis include rosa centifolia petals (pink rose petals), epigallocatechin gallate (a polyphenol found in white and green tea), and tea tree oil 5%.  The aforementioned ingredients have some scientific evidence of efficacy. 

Lastly, try to avoid olive oil and mineral oils as these have been shown in studies to increase the growth of yeast.